Background: Deep pexing or tacking sutures can be useful in certain situations encountered in dermatologic surgery when surface concavities require recreation.
Objective: To examine and discuss some pexing suture techniques that have been described in the past and to outline alternatives.
Methods: Pexing suture techniques are presented in a series of schematic diagrams that follow.
Results: The crisscross tie-over tacking suture as described by Albertini is shown as well as a modification that theoretically lessens complication risk. The pexing buried vertical mattress suture is then presented.
Conclusion: The dermatologic surgeon may find pexing or deep tacking sutures helpful in selected cases.